Exposure therapy is a type of cognitive behavioral therapy (CBT) that’s often used to help people with anxiety disorders learn to manage and cope with their symptoms. In the most basic terms, exposure therapy involves willingly facing what you fear with the help of a qualified, trained mental health professional in a safe, non-threatening environment.
Read on to learn more about how exposure therapy works and how it can be effective for treating various anxiety disorders.
How Does Exposure Therapy Work for Anxiety?
Exposure therapy for anxiety works by subjecting you to a situation, object, or event that triggers your anxiety. With the help of your therapist, you can gently, slowly, and constructively face the things that make you anxiou. Over time, controlled exposure can build your self-confidence while helping decrease anxiety symptoms, along with the frequency and severity of your condition.
Exposure therapy helps you build tolerance. You’ll begin to be able to face the situation, object, thought, event, or other stimuli that might have, at one time, triggered your anxiety symptoms. By repeatedly exposing yourself to what you fear or dread, you can learn and practice coping mechanisms. Ultimately, through effective exposure therapy, you can accept (and truly believe) that the things you once feared really won’t harm you after all.
“When I work with clients on exposure therapy for anxiety and eating disorder symptoms, we create an exposure fear hierarchy list together, ranking which experiences or foods might be the most anxiety-provoking to the least anxiety-provoking. Then together we talk through where we want to start first, and make sure the client has the right coping skills that work for them to help make this a successful exposure experience.”Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC
Types of Exposure Therapy for Anxiety Disorders
There are several types of exposure therapy used to treat anxiety disorders, including:
- In-vivo exposure therapy — This exposure exercise involves facing your fear head-on, in real life. You’ll work closely with your therapist, who understands how to control the exposure, ensuring your safety and well-being.
- Imaginal exposure therapy — In imaginal exposure therapy, a therapist guides you on a journey of vivid imagination as you explore what triggers your anxiety.
- Virtual reality exposure therapy — Modern virtual reality technologies are amazing and are proving to be extremely helpful for various therapeutic applications, including facing your fears in the VR realm. This type of exposure exercise can be very effective for situations where in-vivo exposure therapy is not possible, like addressing the feared situation of deep-sea diving or facing the fear of spiders.
- Interoceptive exposure therapy — Interoceptive exposure therapy uses different techniques to invoke bodily and mental symptoms for the purpose of developing tolerance to those stressors.
- Prolonged exposure therapy — This type of exposure therapy for social anxiety or other types of anxiety typically involves combining imaginal and in-vivo exposure therapy techniques.
There are several types of anxiety disorders that exposure therapy can be beneficial for, including:
- Panic disorder
- Driving anxiety
- Separation anxiety
- Public speaking anxiety
- Social anxiety disorder (SAD)
- Generalized anxiety disorder (GAD)
- Post-traumatic stress disorder (PTSD)
Let’s look closer at how exposure therapy can be effective in addressing the symptoms of each of these anxiety disorders.
In-person or virtual meetings with a licensed therapist will be more effective than attempting self-guided exposure therapy for panic disorder. A 2018 systematic review suggests that an effective treatment for panic disorder might entail the use of cognitive behavioral therapy (CBT), which uses multiple types of therapy techniques, including cognitive restructuring, in-vivo exposure, and interoceptive exposure, among others.
A 2020 pilot study concluded that virtual reality simulation might offer hope in treating the anxiety and fear related to driving. However, more research in larger randomized human trials is needed to verify the efficacy of any type of exposure therapy as an effective technique to treat driving phobia.
Separation anxiety is common in children and adolescents, and exposure therapy is highly recommended as a first-line treatment. The technique involves gently exposing the child to a feared situation while simultaneously encouraging positive thinking and behavior. With time and training, anxiety symptoms can drastically decrease.
Public speaking anxiety
According to 2020 research, virtual reality exposure therapy is proving to be quite effective in helping people decrease their anxiousness about public speaking events. This is true in both adolescents and adults. VR exposure therapy is increasingly becoming a cost-effective, go-to method for addressing various anxiety disorders.
Social anxiety disorder (SAD)
Does exposure therapy work for social anxiety? For many people, it seems to work very well. A 2022 review indicates that exposure therapy for social anxiety disorder can be extremely effective for some people. The findings suggest that some exposure techniques might offer beneficial results in treating anxiety in a situation, although further testing is needed.
Generalized anxiety disorder (GAD)
There hasn’t been a lot of research completed specifically on the effects of exposure therapy for generalized anxiety disorder. Much of the research on exposure therapy’s effects on anxiety disorders has focused on more specific conditions, like post-traumatic stress disorder (PTSD), for instance.
Still, many therapists treat generalized anxiety conditions with either in-vivo exposure therapy, imaginal exposure therapy, or a combination of the two, along with other types of therapy. It’s worth noting that the emerging trend of virtual reality exposure therapy may also be effective for treating GAD. Again, more research is needed to be sure.
Post-traumatic stress disorder (PTSD)
A case report concluded that exposure therapy for PTSD can be effective in decreasing anxiety sensitivity symptoms in people living with post-traumatic stress disorder (PTSD). Continued research will determine the efficacy of interoceptive exposure therapy — or any other type of exposure therapy — in treating all anxiety disorders, including PTSD.
It is important to consider that although these anxiety disorders are all relevant, there are several more not listed that exposure therapy can help with. For instance, you can explore exposure therapy for OCD.
Effectiveness of Exposure Therapy for Anxiety
Does exposure therapy work for social anxiety, PTSD, and other anxiety disorders? In short, yes, it can be effective. Some research backs up the idea that exposure-based therapies can be an extremely effective treatment for people who live with anxiety disorders. There’s even discussion by some experts that it might be time to consider it a first-line of evidence-based treatment.
“It’s powerful to see the enhanced self-esteem and sense of self-efficacy that can result from successful exposure therapy experiences. Certain anxieties around experiences or things can be managed, so if you’re struggling, have hope and find the right therapist to help you navigate these exposures.”Talkspace therapist Kate Rosenblatt, MA, LPC, LMHC
When to Seek Treatment
Exposure therapy for anxiety has benefitted many people, allowing them to better manage their symptoms of anxiety and get back to living a productive, healthy, happy life. Research continues to show promise for exposure therapy as either a front-line or adjunct therapy for various mental health conditions marked by anxiousness, fear, dread, and nervousness.
Exposure therapy takes place in a serene, safe environment where you can trust that no harm will come to you. Working with a skilled therapist or psychologist is essential to get the best results and success. If you’ve been dealing with the symptoms of mild, moderate, or severe anxiety, reach out today to find the best in-person or online therapy for you.